{"id":26654,"date":"2020-03-19T16:01:57","date_gmt":"2020-03-19T16:01:57","guid":{"rendered":"https:\/\/dev.mtelehealth.com\/?p=26654"},"modified":"2020-03-19T16:01:57","modified_gmt":"2020-03-19T16:01:57","slug":"telehealth-news-alert-new-coronavirus-covid-19-considerations-for-telehealth-providers","status":"publish","type":"post","link":"https:\/\/drmiltie.com\/at-home-testing\/telehealth-news-alert-new-coronavirus-covid-19-considerations-for-telehealth-providers\/","title":{"rendered":"Telehealth News Alert: New Coronavirus (COVID-19) Considerations For Telehealth Providers"},"content":{"rendered":"\n

As the novel coronavirus outbreak continues, the federal\ngovernment and commercial health insurers have taken significant steps to\nincrease Americans\u2019 access to treatment and testing. In the past week, the\nfederal government and private insurers have issued a number of guidance\ndocuments expanding coverage and payment requirements in an effort to minimize\nthe spread of the virus. As with any changes in coverage and reimbursement,\nhealthcare providers offering telehealth services should carefully review these\nchanges and take steps to ensure that all regulatory and coverage requirements\nare met prior to submitting claims for reimbursement.<\/p>\n\n\n\n

I.\nMedicare<\/strong><\/p>\n\n\n\n

On March 6, 2020, the bipartisan Coronavirus Preparedness and Response Supplemental\nAppropriations Act of 2020<\/a> (\u201cCoronavirus Appropriations Act\u201d)\nwas signed into law authorizing federal spending to combat the ongoing\ncoronavirus outbreak in the United States. This Act, among other things, gives\nthe United States Department of Health and Human Services\u2019 (\u201cHHS\u201d) secretary\nthe authority to temporarily waive certain Medicare requirements for telehealth\nservices.<\/p>\n\n\n\n

The Centers for Medicare and Medicaid Services (\u201cCMS\u201d)\ncurrently reimburses a limited set of telehealth services provided to Medicare\nbeneficiaries subject to certain criteria under section 1834(m) of the Social\nSecurity Act. Generally, the patient receiving telehealth services must be\nlocated at one of eight \u201coriginating sites\u201d, which include hospitals,\nphysicians\u2019 offices, and rural health clinics. In addition, the originating\nsite must meet certain geographic requirements which have essentially limited the\navailability of telehealth to patients in rural areas. These requirements have\nlong posed a hurdle to the expansion of telehealth despite the industry\u2019s\ndemand for lessened restrictions. However, with the rapid spread of the\ncoronavirus and the possibility of facing large scale isolations and\nquarantines, lawmakers have signaled their willingness to expand access to\ntelehealth to fight against this public health crisis.<\/p>\n\n\n\n

Within the Coronavirus Appropriations Act is the Telehealth\nServices During Certain Emergency Periods Act of 2020, which sets forth the\nwaiver authority for the secretary of HHS regarding the certain telehealth\nrequirements. Under the Telehealth Services During Emergency Periods Act, the\nsecretary is authorized to temporarily waive the originating site and\ngeographic requirements for telehealth services provided to Medicare\nbeneficiaries located in an identified \u201cemergency area\u201d during an \u201cemergency\nperiod\u201d when provided by a qualified provider. To qualify for the waiver, the\nprovider must have treated the patient within the previous three years or be in\nthe same practice (i.e., as determined by tax identification number) of a\npractitioner who has treated the patient in the past three years. The bill also\nlessens the telecommunications requirements by allowing Medicare beneficiaries\nto receive telehealth services via their smartphones (i.e., telephones that\nallow for real time, audio-video interaction between the provider and the\nbeneficiary). Because the federal government has declared a nationwide public\nhealth emergency as a result of the coronavirus, the waiver will apply across\nthe country until there is no longer a nationwide public health emergency.<\/p>\n\n\n\n

II.\nMedicaid<\/strong><\/p>\n\n\n\n

With the passage of the Coronavirus Appropriations Act,\nCongress signaled its intent for Medicare to reimburse providers for telehealth\nservices provided to existing patients so long as the nation remains subject to\na public health emergency as a result of the coronavirus. However, Medicaid\nreimbursement for telehealth continues to vary state by state. On March 6th<\/sup>,\nU.S. Representatives Fred Upton, R-MI, and Joe Kennedy, D-MA, penned a letter<\/a> asking CMS to encourage\nstates to cover all telemedicine services and work with them to expand their\ncapability to do so in an effort to prevent the spread of the coronavirus.\nWhile CMS has published a fact sheet<\/a> of coverage and benefits relating\nto the coronavirus for Medicaid and CHIP, reimbursement remains subject to\nstate-specific requirements.<\/p>\n\n\n\n

III.\nCommercial Payors<\/strong><\/p>\n\n\n\n

Commercial payors are taking steps to further expand access\nto telehealth services by lessening members\u2019 out-of-pocket costs. For example,\nAetna and several Blue Cross Blue Shield plans have waived telehealth visit\ncopays. Blue Cross Blue Shield of North Carolina has taken things one step\nfurther by temporarily covering telehealth services at the same rate as an\nin-person office visit. Put simply, the general consensus throughout the health\ncare industry is that the increased access to telehealth services during this\npublic health emergency is crucial to managing the outbreak.<\/p>\n\n\n\n

IV.\nConsiderations to Keep in Mind<\/strong><\/p>\n\n\n\n

As CMS, state Medicaid agencies, and commercial insurers\ntake steps to expand telehealth coverage and reimbursement, health systems and\npractices are increasingly likely to turn to telehealth in the fight against\nthe coronavirus. When expanding telehealth practices, providers should keep the\nfollowing in mind to ensure their telehealth practice remains in compliance as\nefforts to expand services continue to evolve:<\/p>\n\n\n\n

Licensure<\/em>. Physicians must continue to hold appropriate\nlicensure to provide services to patients in other states and follow the\napplicable licensure and telehealth laws;<\/p>\n\n\n\n

Scope of Practice.<\/em> Be mindful that applicable\nstate Practice Acts for non-physician practitioners remain in effect and take\nsteps to ensure that telehealth services are rendered only by appropriately\nlicensed and supervised practitioners;<\/p>\n\n\n\n

Credentialing<\/em>. Physicians rendering services must\nhold appropriate credentialing at hospitals, when applicable;<\/p>\n\n\n\n

Controlled Substance Prescribing.<\/em> Any prescribing\nof controlled substances must be done in accordance with the telemedicine\nlimitations set forth under the Ryan White Act;<\/p>\n\n\n\n

Data Privacy and Security<\/em>. The Coronavirus\nAppropriations Act makes no mention of the Health Insurance Portability and\nAccountability Act (\u201cHIPAA\u201d) or its implementing regulations. Providers should\ncontinue to provide telehealth services via HIPAA-compliant telecommunications\nmethods; enter into business associate agreements with technology vendors, when\napplicable; and comply with the minimum necessary standard for disclosures of\nprotected health information;<\/p>\n\n\n\n

Fraud, Waste, and Abuse Risks<\/em>. As with any change or\nexpansion of coverage and benefits, be sure to carefully consider all fraud,\nwaste, and abuse implications. The Anti-Kickback Statute, Stark Law, and\nBeneficiary Inducement prohibitions continue to apply.<\/p>\n","protected":false},"excerpt":{"rendered":"

As the novel coronavirus outbreak continues, the federal government and commercial health insurers have taken 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